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Each time a discovery is made in the search for why an unusually large number of local residents are developing a rare form of cancer, it generates more questions than answers. There are no answers yet. But the research continues.

Laura Werner, a senior regional representative of the Agency for Toxic Substances and Disease Registry, a division of the Pennsylvania Department of Health, spoke to about 50 citizens who gathered at the Tamaqua Public Library on Thursday for an update on the research into the high number of polycythemia vera cancers in the tri-county area of Schuylkill, Luzerne and Carbon counties. She said there are 18 different paths of research underway, each aimed at unraveling questions into why the high cancer rate exists locally.

When the cancer cluster was confirmed by the state Department of Health in 2004, Warner said, "that raised more questions than answers, which, unfortunately, is going to be a theme."

The agency joined the Department of Health investigation in 2006. The agency reviewed medical records and conducted genetic testing on area residents, which confirmed the unusually high cluster of PV cancers in an area that stretches from Tamaqua through McAdoo into Hazleton. Ground zero for the cluster appears to center around Ben Titus Road off state Route 309 between McAdoo and the Ryan Township community of Hometown.

With $7.99 million in federal funding, the study branched down four paths: epidemiology, genetics, toxicology and environmental protection with nationally recognized experts involved in the investigation.

Partnering in the investigation is the University of Pittsburgh, which is comparing the pattern of PV in other areas of state where residents have similar characteristics and researching how complete and accurate reporting to the state cancer registry is. Pittsburgh experts are also working to improve physician reporting of hemotologic cancers.

Other research partners include:

n Geisinger Health Systems, which is studying how PV is diagnosed and analyzing data on how accurate the diagnoses are. Geisinger is also working to educate doctors on how to diagnose and treat PV, and conducting bi-annual follow-up examinations of local citizens who were found, through genetic testing, to carry a mutated gene that is frequently found in PV patients. Geisinger is also analyzing the prevalence of the genetic mutation throughout the state.

n Drexel University, which is working to identify risk factors that might be linked to PV and similar cancers.

n Mount Sinai School of Medicine, which is conducting genetic studies, including whether patients with PV in the cluster area are genetically prone to the disease, and examining genetics of local PV patients compared to PV patients in other regions. Mount Sinai is also working with the agency to catalogue the number of people in the nation who carry the genetic mutation, called JAK2 mutation. The school is also examining whether various environmental contaminants can cause DNA damage.

n The Myleoproliferative Disease Research Consortium Tissue Bank, which is collecting and storing tissue samples from PV patients in the cluster area.

n Equity Environmental Engineering, which is examining drinking water and air emissions that may have lead to, or may be connected with, the high local PV rate.

n The agency developed a database of federal, state and other relevant data related to possible human exposure to contaminants from hazardous waste sites and other operations, industries or businesses that release toxic material within the cluster area.

n The state Department of Environmental Protection, which is collecting data on contaminants in the water flowing out of the McAdoo Superfund site and three waste coal burning plants as well as residential sampling.

Werner said the investigators who are collecting data in the communities will complete their field work by the end of the month. Each agency is expected to compile the information into individual reports that will be submitted to the agency for a review process.

As the field research and investigation continue, Werner said Thursday there was no new information to report because the work is still underway.

"Do we have results to share with you? We do not, because the research is still going on at this point," Werner said. "We just felt it was important to come back and tell you where the (federal research funding) went and what we are doing."

Following a brief presentation on the status of the investigation, residents were invited to speak informally with experts from the various medical and university agencies.

Joseph Murphy of Hometown, a member of the citizen committee that serves as liaison between residents of the community and the government and research experts, said it is frustrating that there are no definitive answers to the dire health issues facing residents. But it's also gratifying that the federal government has put nearly $8 million into the research project.

When the research is complete and the reports are finalized, Murphy said he hopes the process remains transparent and citizens are kept "in the loop."

For more information on the citizen arm of the investigation, contact Murphy at 570-668-9009 or email: jmmurph@verizon.net.

mlight@standardspeaker.comWhat: An open house held by the U.S. Agency for Toxic Substances and Disease Registry to provide an update on polycythemia vera research.

Where: The Tamaqua Library, 30 S. Railroad St., Tamaqua.

When: Thursday from 6 to 8 p.m. with speeches occuring on the hour at 6 and 7 p.m.

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